Psychosocial and cultural reasons for delay in seeking help and nonadherence to treatment in Indonesian women with breast cancer: A qualitative study.

Abstract

The aim of this study was to explore reasons for delay in seeking medical help and nonadherence to treatment in Indonesian women with breast cancer. Method: Semistructured interviews were conducted by purposive sampling, using a consecutive sample of 50 breast cancer patients who were treated at the Outpatient Surgical Oncology Clinic of Hasan Sadikin Hospital in Bandung, Indonesia. Interviews were recorded, transcribed verbatim, and coded using qualitative software. Codes were merged into main themes that were subsequently mapped onto the study's aim. Results: Eight main themes concerning reasons for delay in seeking medical help and treatment nonadherence emerged, namely: lack of awareness and knowledge, cancer beliefs, treatment beliefs, financial problems, emotional burden, severe side effects, paternalistic style of communication, and unmet information needs. Conclusion:This study has identified several modifiable psychosocial and cultural factors related to delay in seeking help and nonadherence to treatment in breast cancer patients. We suggest that the provision of extensive information through media campaigns, treatment decision aids, and caregiver and patient education are needed to change the illness behaviors of Indonesian breast cancer patients.

Characterizing breast cancer treatment pathways in Kumasi, Ghana from onset of symptoms to final outcome: Outlook towards cancer control

“…This is partly due to patients waiting on average almost 11 months between initial detection of symptoms and seeking organized cancer care. While this finding is consistent with previous studies in Ghana, it is elevated compared to both other LMICs and high income countries, and has a significant effect on patient prognosis and available treatment options [4, 10, 12, 15, 20]. …”

“…These factors –usually financial, geographical, and sociocultural- have also been implicated in motivating patients to seek alternative therapies [3–8, 12, 14–17, 19–22]. Fear of mastectomy has been singled out as one of the major causes for delaying care and/or seeking alternative therapies; given that many women die shortly after mastectomy (due to late stage at presentation), there is a commonly perceived link between the procedure and death [4, 16, 21].…”

Why do People Avoid Medical Care? A Qualitative Study Using National Data

“…[1][2][3][4]7,10,11,[32][33][34][35][36][37] Interestingly, the categories of reasons that emerged from the present study mapped almost directly onto a general psychological model of responses to negative events-Crisis Decision Theory 30 -which has not previously been used as a framework for understanding medical care avoidance. Crisis Decision Theory posits that people respond to negative events first by appraising the severity of threat, next by identifying available response options, and lastly by evaluating available response options.…”

Temperament, Beliefs About Pain Control, and Pain Intensity in Endometriosis Patients

“…Many sociodemographic factors such as age, low socioeconomic status, area of residence, and appraisal of health services may be associated with some women delaying seeking medical consultation (Kannan & Veazie, 2015; Khakbazan, Taghipour, Latifnejad Roudsari, & Mohammadi, 2014; Robinson, Christensen, Ottesen, & Krasnik, 2011). Several factors associated with help-seeking delay include psychological factors such as: lack of awareness and knowledge of the disease, disease beliefs, treatment beliefs, and emotional distress (Iskandarsyah et al, 2014). Some data showed that a high level of initial emotional response to severe illness symptoms discovery was associated with a shorter delay in seeking medical help (Meechan, Collins, & Petrie, 2003).…”